2 224例女性月经史及绝经年龄、绝经年限与骨质疏松症相关性研究

目的 分析兰州市两社区45岁以上女性初潮年龄、月经周期、月经天数及绝经年龄、绝经年限与骨质疏松症相关性。方法 采用现场问卷调查方式获取初潮年龄、月经周期、月经天数及绝经年龄、绝经年限等相关资料，应用双能X线骨密度检测仪测定骨密度。结果 ①骨质疏松症患病率为32.73 %，患病率随初潮年龄增加（P<0.01）及月经周期延长（P<0.05）而上升；患病率随月经天数增加而逐渐降低，但差异无统计学意义（P=0.104）；②绝经后女性患病率（35.91 %）显著高于未绝经女性（5.22 %），组间差异存在统计学意义（P＜0.01）；不同绝经年龄与绝经年限组间差异存在统计学意义（P＜0.01）。③单因素Logistic分析显示，初潮年龄、绝经史、绝经年龄、绝经年限与骨质疏松相关（P<0.05）。结论 兰州市两社区45岁以上女性骨质疏松症发生与初潮年龄、绝经史、绝经年龄、绝经年限相关，初潮年龄早、月经周期长、绝经年龄早、绝经年限长的绝经后女性应提早筛查、预防骨质疏松症的发生。     

绝经后女性血清硒水平与骨质疏松骨密度和骨代谢指标相关性研究

目的探索血清硒水平与绝经后妇女骨代谢指标以及腰椎和髋部骨密度之间相关性。方法检测156例正常骨密度和162例骨质疏松症的血清硒、25-羟基维生素D、PTH、骨钙素、PINP、CTX和NTX/Cr等指标水平。腰椎和股骨颈的BMD通过双能X线吸收法测量。探索了血清硒水平与骨密度的关系。结果骨质疏松症女性的血清硒水平低于正常骨密度的女性(P0.05)。在骨质疏松症妇女中,血清硒水平与年龄、绝经年限、BMI、PTH、骨钙素、PINP、CTX和NTX/Cr水平呈负相关,与25-羟基维生素D水平呈正相关。在正常骨密度组,血清硒水平与这些参数均未发现明显的相关性。调整年龄和BMI后,腰椎和股骨颈骨密度与血清硒及25-羟基维生素D水平呈显著正相关,与绝经年限、PTH、骨钙素、PINP、CTX和NTX/Cr呈负相关。对年龄和BMI进行调整后,进行多元回归分析以确定BMD的预测因子,血清硒和PINP、CTX是腰椎和股骨颈骨密度的显著预测因子。结论绝经后女性患者血清硒水平降低与腰椎和股骨颈骨密度降低密切有关。     

初产年龄与绝经后中国妇女患骨质疏松风险相关性研究

目的探讨初产年龄与绝经后中国妇女患骨质疏松风险相关性。方法采用2015年至2018年我院骨密度测试数据,包括253名绝经后妇女。骨质疏松症的诊断是使用世界卫生组织的T评分标准(股骨颈或腰椎T评分<-2.5)。根据第一次分娩的年龄将参与者分为3组:<23岁,24~29岁和>30岁。结果年龄越大、体质指数越低、钙摄入量越低、月经初潮越晚、绝经越早,患骨质疏松症的风险增加,而激素治疗和口服避孕药的使用与骨质疏松症风险降低有关。第一次分娩发生在24~29岁的绝经后妇女与30岁之后首次分娩的妇女相比骨质疏松症风险显著增加(优势比2.124;95%置信区间,1.096~4.113;P=0.026)。结论绝经后妇女的第一次分娩发生在24至29岁期间患骨质疏松症的风险显著增加。     

绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系分析

目的 探讨绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系.方法 调查248名健康的绝经后妇女的年龄、绝经年龄、绝经年限,测量身高、体重、正位腰椎（L2～L4）、髋部骨密度进行分析.结果 随着绝经年限的增长,腰椎和髋部骨密度逐渐降低.单因素相关分析表明年龄、绝经年限与腰椎及髋部各部位骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.调整身高、体重指数后,年龄、绝经年龄与腰椎及髋部骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.多元逐步回归分析显示绝经年限与腰椎、股骨颈及股骨大转子的骨密度呈显著负相关（P＜0.01）,年龄与腰椎、股骨颈及Ward三角区骨密度呈显著负相关（P＜0.05）.结论 年龄、绝经年限与腰椎和髋部骨密度有关.     

长春地区女性骨密度与年龄、绝经年限、体重指数的相关性研究

目的调查吉林省长春地区4613例25~79岁女性腰椎正位L1-L4 TOTAL骨密度(BMD),分析长春地区女性骨质疏松患病率,研究女性腰椎BMD与年龄、绝经年限、体重指数的相关关系。方法采用美国Hologic公司Discovery WA型骨密度仪检测受试者腰椎正位L1-L4 TOTAL骨密度。将4613例受试者腰椎BMD检测结果按5岁为一年龄段分组,应用SPSS19.0统计学分析软件进行分析。腰椎BMD和骨质疏松患病率与年龄、绝经年限、体重指数的相关性采用直线相关分析。结果30岁以后,随着年龄增长,腰椎BMD值呈下降趋势,骨质疏松患病率升高,年龄与腰椎BMD呈负相关,与OP患病率呈正相关;随绝经年限延长,BMD值降低,OP患病率升高,绝经年限与腰椎BMD呈负相关,与OP患病率呈正相关。低体重指数组,腰椎BMD值最低,OP患病率最高;随体重指数增加,腰椎BMD增加,骨质疏松患病率降低,体重指数与腰椎BMD呈正相关,与骨质疏松患病率呈负相关。结论年龄、绝经年限、体重指数是骨密度的重要影响因素,增龄、绝经年限延长与低体重指数是骨质疏松发生的危险因素。     

绝经后女性骨质疏松性椎体骨折与腰椎体骨密度的相关性

随着我国步入老龄化社会,骨质疏松症的患病率明显升高。骨质疏松症最严重的危害来自骨质疏松性骨折,绝经后女性尤其多见。由于脊柱独特的解剖学和生物力学特点,骨质疏松患者更易发生椎体骨折。骨密度测量是诊断骨质疏松的金标准。本文通过回顾近年来相关文献,探讨腰椎体骨密度检测对绝经后女性骨质疏松性椎体骨折的意义,发现:绝经后骨质疏松性椎体骨折患者的BMD水平比绝经后骨质疏松症但无脊椎骨折者明显减少;绝经后骨质疏松症患者的BMD水平越低,其发生椎体骨折的风险越高;有椎体骨折史的绝经后骨质疏松症患者的BMD水平与发生再次椎体骨折的风险呈负相关。药物干预通常可明显提高绝经后骨质疏松症患者的BMD水平,同时还可减少椎体骨折的发生。尚存在一些不足:腰椎骨密度可能出现假性增高;需进一步探讨预测骨质疏松性椎体骨折的骨密度阈值;药物干预的研究中BMD水平与椎体骨折发生的相关性并没有得到深入研究;缺少大规模的绝经后骨质疏松性椎体骨折的流行病学,现有研究也大都存在病例收集方法不规范、样本量小、年龄分布存在差异等不足。对绝经后骨质疏松性椎体骨折的深入研究需要多学科共同协作。     

绝经后妇女椎体骨折与骨密度的对照研究

目的探讨绝经后妇女骨质疏松性椎体骨折与骨密度的关系。方法随机选择椎体骨折的绝经后妇女120例为骨折组，无椎体骨折的120例绝经后妇女为对照组。两组的年龄、身高、体重等差异无显著性，均行胸腰椎正侧位X线摄片。用双能X线吸收仪（DXA）测量腰椎（L2-4）前后位及髋部骨密度（BMD）和T值。结果骨折组腰椎及髋部BMD和T值均低于对照组（P≤0．05）。结论腰椎BMD降低与绝经后妇女的骨质疏松性椎体骨折相关，髋部骨密度值的降低在一定程度上也能提示骨折的危险性。绝经后骨质疏松妇女应重视BMD变化，预防椎体骨折的发生。     

绝经妇女绝经后年限及年龄与骨量丢失率关系

目的探讨绝经后妇女的绝经年限及年龄与骨量丢失率关系。方法1999年5月-2003年4月,对已绝经的1467例妇女进行骨密度测定,并对不同绝经后妇女年龄、绝经年限与骨密度关系进行分析。结果1467例绝经后妇女中,以绝经1-5年期间和40-45岁时各部位骨密度作为基线值比较,绝经已超过35年或年龄大于80岁时各部位骨密度最低。其中按绝经年限腰椎、股骨颈、大转子、华氏三角区在绝经后6-10年间和超过35年时丢失速度最快;按年龄腰椎在56-65岁、股骨颈和华氏三角区在61-65岁、大转子在71-75岁及各部位大于80岁时丢失速度最快。结论绝经后妇女绝经年限及年龄增加,腰椎、股骨颈、粗隆、华氏三角区骨量丢失增加。绝经年限及年龄不同,各部位丢失速度不同。     

骨硬化蛋白水平与绝经后妇女体脂含量及骨密度的相关性研究

目的 探讨绝经后妇女血清骨硬化蛋白水平与体脂含量及骨密度(bone mineral density, BMD)之间的相关性。方法 对230名年龄在50~75岁之间健康的绝经后妇女进行横断面研究。通过双能X射线吸收仪测量受试者全身、腰椎、左侧股骨BMD及全身脂肪和肌肉含量。通过定量夹心酶联免疫吸附法测量受试者血清骨硬化蛋白水平。结果 与非骨质疏松症的女性相比,骨质疏松女性血清硬化蛋白水平显著降低(P <0.05)。血清骨硬化蛋白水平与体重和脂肪量呈正相关(P <0.05)。即使在校正年龄、绝经年龄、身高和体重之后,骨硬化蛋白水平与全身及各个部位的BMD均呈正相关(P <0.05)。多元线性逐步回归分析显示,与年龄、绝经年龄、脂肪量和肌肉量相比,血清骨硬化蛋白水平是全身和腰椎BMD最重要的决定因素(P <0.05)。年龄与血清硬化蛋白对髋部BMD的影响相似。结论 在绝经后妇女中,骨质疏松症患者的血清硬化蛋白水平低于非骨质疏松症患者。血清硬化蛋白与全身、腰椎、髋部的BMD和体脂含量呈正相关。     

13629例女性初潮年龄、生育次数、绝经年限与骨密度相关性研究

目的研究女性月经初潮年龄、生育次数、绝经年限与前臂远端骨密度的相关关系。方法周围型双能X线骨密度仪(pDEXA)检测前臂远端骨密度,用自制的问卷调查表记录受试者月经初潮年龄、生育次数及绝经年龄、绝经年限,测量身高、体重。结果月经初潮年龄与骨密度明显负相关,生育次数与骨密度负相关,绝经年限与骨密度负相关。结论月经初潮年龄决定峰值骨量,生育次数和绝经是骨质疏松的危险因素。     

Bone mass and mineral metabolism in HIV+ postmenopausal women

The objective of this cross-sectional study was to estimate the prevalence of and risk factors for osteoporosis in HIV+ postmenopausal women. Bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) and biochemical indices of mineral metabolism were measured in 31 Hispanic and African American HIV+ postmenopausal women. BMD was compared with 186 historical controls, matched for age, ethnicity and postmenopausal status. Mean BMD was significantly lower at the lumbar spine and total hip in the HIV+ group, as compared with controls. Prevalence of osteoporosis was higher in the HIV+ group than controls at the lumbar spine (42% vs 23%, p =0.03) and total hip (10% vs 1%, p =0.003). Among HIV+ women, time since menopause and weight were significant predictors of BMD, while duration or class of antiretroviral therapy (ART), AIDS diagnosis, nadir CD4, steroid use, and vitamin D deficiency were not. Prevalence of osteoporosis is substantially higher in HIV+ Hispanic and African-American postmenopausal women than in controls. Established osteoporosis risk factors were more important in predicting BMD than factors associated with HIV infection and ART. Long-term management of the growing female HIV population should include the evaluation for and management of osteoporosis.     

Bone mineral density in old age: the influence of age at menarche and menopause

Being aware that age at menarche, age at menopause, and length of fertile period influence bone mineral density (BMD) in the early postmenopausal period, we have failed to find any earlier studies where such an influence on the axial skeleton has been studied in old age when the incidence of hip fracture starts to increase. A large cohort of women, all 75 years old (n = 1044) participated in the Malmö Osteoporosis Prospective Risk Assessment (OPRA) Study. The BMD of the lumbar spine and femoral neck was assessed by a dual-energy X-ray absorptiometry (DXA) technique. Age at menarche and at menopause was recalled with a questionnaire. Also, data on estrogen medication was collected. We found that, after excluding ever-users of potent estrogens (n = 49), there was a small but significant correlation of early menarcheal age with high BMD of the lumbar spine (r = –0.08; P = 0.017) and femoral neck (r = –0.10; P = 0.002) at age 75. Excluding the extremes (5% of the women) with very early or very late menarche, age at menarche no longer influenced the BMD in old age (r = –0.06; P = 0.113). Age at menopause had no influence on the BMD of the lumbar spine (r = 0.04; P = 0.246) or femoral neck (r = 0.00; P = 0.985), at age 75. The length of the fertile period did not influence BMD in old age. The influence of menarcheal or menopausal age on BMD at age 75 was not substantially altered after including body mass index (BMI) in a multiple regression model. Age at menarche or menopause seems to be of limited or no importance as a risk factor for osteoporosis when subjects are age 75 or older.     

Relation of early menarche to high bone mineral density

The study of background factors in individuals with high bone mineral density (BMD) may provide useful information in the prevention of osteoporosis. We investigated the relationship of reproductive factors to BMD. In 519 female volunteers (327 postmenopausal and 192 premenopausal women) ranging in age from 21 to 74 (mean 52.3 ±11.8) years, spinal BMD values were obtained using both quantitative computed tomography and dual x-ray absorptiometry. The z score was calculated from the mean BMD in each 5-year age group, and high BMD and low BMD was defined as BMD with z score >+1.5 and <-1.5, respectively. Normal BMD was defined as BMD within the range-1.0 <z score <+1.0. Long reproductive period, early menarche, and late menopause were associated with high BMD. Among these, the reproductive period showed the strongest association with BMD. In postmenopausal women, early menopause had a significant relationship with low BMD, and early menarche also had some relation to high BMD. In premenopausal women, there was a significant relationship between early menarche and high BMD. The age at menarche may have a strong association with peak bone mass, as suggested by the positive correlation of early menarche with high BMD observed in this study. It is considered important to prevent risk factors that disturb the beginning of menstruation in adolescent girls.     

The impact of reproductive and menstrual history on bone mineral density in Chinese women.

Low bone mineral density (BMD) is an important risk factor for osteoporotic fractures. The impact of gynecological history on BMD is of great concern, but the results are largely inconsistent. In this study, we investigated the association of gynecological history with BMD in 214 postmenopausal women (60.4 +/- 5.7 yr), as well as with peak bone density (PBD) in 428 premenopausal women (30.8 +/- 5.3 yr) from Shanghai City in China. BMD was measured at lumbar spine (L1-4) and total hip by dual energy X-ray absorptiometry. Raw BMD values were adjusted by age, age2, height, and weight. In the postmenopausal group, more parity had significantly detrimental effects on BMD at both the spine and hip (p < 0.01). The age of the first delivery, the duration of lactation, and the age at menarche did not show significant impacts on BMD (p > 0.05). More years since menopause only had marginally significant decreasing effects at the spine (p = 0.09), but not at the hip (p > 0.10). In the premenopausal group, none of the three reproductive factors had significant impact on PBD (p > 0.05); the age of menarche inversely affected PBD at both the spine (p < 0.01) and hip (p < 0.05). Our results suggest that some gynecological events might influence BMD variation in healthy Chinese women.     

The relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women

The aim of this cross-sectional study was to use a novel method of data analysis to demonstrate that patients with osteoporosis have significantly lower ultrasound results in the heel after correcting for the effect of bone mineral density (BMD) measured in the spine or hip. Three groups of patients were studied: healthy early postmenopausal women, within 3 years of the menopause (n=104, 50%), healthy late postmenopausal women, more than 10 years from the menopause (n=75, 36%), and a group of women with osteoporosis as defined by WHO criteria (n=30, 14%). Broadband ultrasound attenuation (BUA), speed of sound (SOS) and Stiffness were measured using a Lunar Achilles heel machine, and BMD of the lumbar spine and left hip was measured using dual-energy X-ray absorptiometry (DXA). SOS, BUA and Stiffness were regressed against lumbar spine BMD and femoral BMD for all three groups combined. The correlation coefficients were in the range 0.52–0.58, in agreement with previously published work. Using a calculated ratio R, analysis of variance demonstrated that the ratio was significantly higher in the osteoporotic group compared with the other two groups. This implied that heel ultrasound values are proportionately lower in the osteoporotic group compared with the other two groups for an equivalent value of lumbar spine and femoral neck BMD. We conclude that postmenopausal bone loss is not associated with different ultasound values once lumbar spine or femoral neck BMD is taken into account. Ultrasound does not give additional information about patterns of bone loss in postmenopausal patients but is important in those patients with osteoporosis and fractures.     

Determinants of bone mineral density in Chinese-American women

Summary Few data are available regarding bone mineral density (BMD) and its determinants among Chinese Americans. We identified determinants of BMD among 359 Chinese-American women in order to identify risk factors for low BMD in this burgeoning population. BMD in Chinese-American women is influenced by a number of factors, including immigration. Introduction Osteoporosis and low BMD are common among Chinese women, including Chinese Americans, who are a growing population at risk for osteoporosis in the US. Few data are available regarding BMD and its determinants among Chinese-American women. Methods In this study, we examined predictors of BMD in 359 ambulatory Chinese-American women, ages 20–90, using stepwise multiple regression analysis. Variables in the model included age, weight, height, menarche age, years since menopause, immigration age, years in US, percentage of life in US, number of pregnancies, oral contraceptive use, family history of osteoporosis, family history of hip fracture, daily calcium intake, exercise, time outdoors, alcohol consumption and tobacco use. Results Among premenopausal women, weight was the strongest predictor of BMD, accounting for 10.5% of the variance at the lumbar spine (LS), 15.2% at the total hip (TH) and 16.6% at the femoral neck (FN). Time outdoors was also a positive predictor of BMD (1.4% at LS, 2.8% at TH and 1.6% at FN), while family history of osteoporosis (1.4% at TH) and age (3.7% at FN) were negative predictors. Among postmenopausal women, greater BMD at the LS and TH was associated with greater weight and earlier immigration age. Weight accounted for 16.4% of the variance at the LS and 19.8% at the TH; immigration age accounted for 3.1% of the variance at the LS and 4.1% at the TH. At the FN, years since menopause and weight were predictors of BMD, accounting for 14.4% and 8.7% of the variance, respectively. While older age at immigration had a negative effect on BMD, years in and proportion of life in the United States were not significant predictors of BMD. Conclusions Bone mineral density in Chinese-American women is influenced by a number of biological and lifestyle factors, including immigration. The results of this study provide new insights into risk factors for low bone density as they relate to environmental determinants in the growing population of Chinese-American women.     

北京市中老年女性月经及身体成分与骨密度的相关性研究

目的调查北京市中老年女性年龄、月经和身体成分特征,分析其与骨密度的关系以及对骨密度的影响。方法招募45～80岁女性384名,调查受试者月经状况,包括初潮年龄、绝经年龄和绝经年限;测试受试者腰椎、左股骨颈、左髋以及全身骨密度,并测试全身脂肪和肌肉含量,由此计算脂肪含量指数(fat mass index,FMI)、肌肉含量指数(lean mass index,LMI)和四肢骨骼质量指数(appendicular skeletal muscle mass index,ASMI)。采用Pearson相关和多元逐步回归模型分析各因素与骨密度的关系。结果相关性结果显示,年龄、绝经年限、初潮年龄与骨密度呈显著负相关,绝经年龄、LMI、FMI和ASMI与骨密度呈显著正相关。多元逐步回归分析结果显示,绝经年限与各部位骨密度均呈显著负相关,ASMI与各部位骨密度均呈显著正相关,FMI仅与全髋和全身骨密度具有显著相关性,初潮年龄和绝经年龄仅与腰椎和全身骨密度具有显著相关性。结论绝经年限是中老年女性骨密度的独立危险因素,而ASMI则为独立保护因素,绝经年龄、初潮年龄以及FMI对中老年女性骨密度的影响存在部位差异性。     

Prevalence and awareness of osteoporosis among postmenopausal Palestinian women

Summary

The prevalence and awareness of postmenopausal osteoporosis was assessed among 569 postmenopausal women randomly selected from the population. Osteoporosis was assessed based on bone mineral density (BMD) values at three indicative sites. The results indicate a significant prevalence of the disease among this fraction of the population with a poor knowledge of its risk factors.

Introduction

Postmenopausal osteoporosis is a major health problem at the individual and population levels. Assessment of its prevalence and awareness of risk factors provide the basis for health plans to control the disease. No previous studies have been done in our population. A cross-sectional study including 569 postmenopausal women showed a significant prevalence of osteoporosis with a poor awareness of risk factors.

Methods

Included in the study were 569 randomly selected postmenopausal women (≥49 years of age). BMD was measured in 505 subjects at the lumbar spine, femoral neck and total hip using dual energy x-ray absorptiometry. Awareness was evaluated using a special questionnaire.

Results

Osteoporosis affected the lumbar spine, femoral neck and total hip in 24%, 14% and 29.7% of subjects, respectively. There was a significant negative correlation (p<0.001) between age and number of years since menopause and BMD at all the sites evaluated. Conversely, BMD increased at the three sites as weight, height and BMI increased. There was a significant positive correlation between BMD at the three sites and the physical characteristics of the subjects (weight, height and BMI) (p<0.001 at the hip and femoral neck, and p=0.05 at the lumbar spine). BMD was higher at the lumbar spine and femoral neck among subjects aware of the disease (0.893 and 0.746 g/cm², respectively) than among subjects unaware of the disease (0.835 and 0.712 g/cm², respectively). This investigation is the first among Palestinian women in this region. It indicates the urgent need for a comprehensive national programme to reduce the incidence of osteoporosis.

Conclusion

Postmenopausal osteoporosis is significant among the Palestinian population and there is a poor awareness of the risk factors.     

50例绝经后高疾病活动期的女性类风湿关节炎骨密度的临床观察

目的观察绝经后高疾病活动期的女性类风湿关节炎患者骨矿物质密度水平的变化。方法收集50例绝经后女性RA患者一般临床资料,包括年龄、RA病程、绝经年龄、ESR、CRP、RF、抗CCP抗体、DSA28评分及雌二醇水平,应用双能X线吸收法(DXA)测定50例患者腰椎L_(1-4)和左髋关节部位的骨密度,分析其骨密度(BMD)的情况。结果 1.50例绝经后女性RA的DSA28评分大于5.1,属高疾病活动期,骨质疏松组发生率52%;远高于骨量减少组(30%)及骨密度正常组(18%)。2.骨质疏松组的绝经年龄比非骨质疏松组明显提前(P=0.005),抗CCP抗体水平明显升高(P=0.037),有统计学意义,但在年龄、病程、RF、DSA28评分及雌激素方面两者无统计学差异。3.Logistic回归分析结果显示抗CCP抗体(OR值1.025,P=0.041)是绝经后高疾病活动女性RA骨质疏松的独立危险因素。4.骨质疏松组,腰椎总骨密度较髋关节显著降低(P0.001);腰椎组内比较以腰1椎体BMD最低,而后依次为腰2,腰3、腰4(P=0.0003),左髋关节组内比较以大转子BMD最低,而后依次为股骨颈、小转子(P0.0001)。结论绝经后高疾病活动期的女性RA患者存在明显的骨质疏松,以腰椎骨密度(特别L_1)下降最明显;抗CCP抗体可能是高疾病活动期的女性类RA患者发生骨质疏松的危险因素。